Competent Care Research Articles

More than law‐abiding: A multi‐staged consumer study on brand morality

AbstractToday's consumers expect brands to act morally to win their hearts and wallets. Yet, existing marketing literature provides little clarity on what this behavior entails and how it differs from acting ethically. This study aims to clarify these concepts and inspire further research. Our consumer‐centric research adopted a multi‐theory and multi‐method approach, coupling Moral Foundations with Morality as Cooperation theories, 12 in‐depth interviews and three surveys with 1229 respondents from two opposite national cultures. We present a Brand Morality scale involving three meaningful dimensions: brand care, brand compliance and brand competency. Brand care is more influential in establishing a moralistic image than the other dimensions. We also learn that while consumers from different national cultures may value the same set of BM dimensions on a cognitive level, they may interpret and react differently on a behavioral‐intent level. Our unique contributions include (i) presenting a 12‐item Brand Morality scale that is theoretically meaningful and practically applicable to brands, (ii) demonstrating the co‐utility of two under‐considered theories, (iii) clarifying the nuanced distinctions of brands acting morally versus ethically, and (iv) shedding light on consumers' perceptual definitions of BM may be consistent between nations, but their behavioral interpretations may vary depending on their local cultures.

Characteristics of advanced practice nurses’ clinical competence in primary healthcare settings: a scoping review protocol

Objective: This scoping review aims to identify the clinical competency characteristics, in terms of knowledge, skills, and attitudes, of advanced practice nurses in primary care settings. Introduction: Although much has been written about the competencies of advanced practice nurses, more detail about the skills, knowledge, and attitudes that inform their clinical competency in primary health care needs to be ascertained. This will promote the development, implementation, and evaluation of advanced nursing practice in contexts where it is unavailable. Inclusion criteria: Studies that address the clinical competency characteristics of advanced practice nurses in primary health care settings will be considered for inclusion. Methods: This review will be conducted according to JBI methodology for scoping reviews. A comprehensive search will be conducted in PubMed, CINAHL (EBSCOhost), Web of Science, Scopus, Virtual Health Library (VHL), Scientific Electronic Library Online (SciELO), Embase (Elsevier), Science Direct (Elsevier), Cochrane Library, and Google Scholar for primary and secondary qualitative, quantitative, and mixed methods studies on the topic of relevance. Gray literature will be searched in DART-E, TESES CAPES, CAUL (Australian Digital Theses), and Theses Canada Editorials. Letters, editorials, commentaries, conference abstracts, and documents published by advanced practice nurses’ associations will also be considered for inclusion. Two independent reviewers will screen the studies at title and abstract and full text. The same reviewers will extract relevant data using an instrument developed by the reviewers. These data will be presented in a narrative synthesis to facilitate the analysis of the evidence found. Review registration: Open Science Framework https://osf.io/tnrjz/

Empowering Wellness: A Comprehensive Narrative Review of Cancer Prehabilitation from Treatment Onset to Surveillance.

Cancer prehabilitation, defined as a process occurring between cancer diagnosis and the onset of acute treatment, is highlighted for its ability to enhance physical and mental health results while decreasing overall healthcare costs. This summary introduces the concept of cancer prehabilitation and emphasises the crucial role of oncology nurses in rehabilitation care. The cancer treatment plan of prehabilitation requires timely and efficient assessment across the care continuum, focusing on enhancing outcomes at every stage of cancer. The battle with cancer involves three different assessments with distinct goals: i) prehabilitation evaluation before treatment, ii) early post-treatment evaluations of rehabilitation and iii) final evaluations of health promotion. Analyses and treatments for significant side effects or complications associated with the treatment specifically for prehabilitation are recommended. The roles of coordination, counseling, preparing for discharge and teaching are outlined as integral components of a cancer nurse's responsibilities in the prevention of cancer. A literature search from March 2016 to June 2023 was conducted using the keywords 'neoplasms,' 'cancer,' 'prehabilitation,' 'continuum of care,' 'care continuum,' 'patient care continuity,' 'epidemiology,' 'therapeutics,' 'health,' 'prevention and control' and 'guidelines as topic.' The findings suggest that care coordinators or navigators for cancer should be educated to assess the physical and psychological status of patients once a cancer diagnosis is confirmed, particularly for those awaiting surgery at home. To enhance their competence in prehabilitation care, oncology nurses are encouraged to gain knowledge of certain tumours' outcomes and cancer-related treatments. Additionally, improving the ability to evaluate patients' functional status and emotional distress is crucial for oncology nurses involved in cancer prehabilitation.

Are nurses and patients willing to work with service robots in healthcare? A mixed-methods study

IntroductionScholars have become increasingly interested in incorporating robots into healthcare. While there is a growing body of research examining nurses’ and patients’ attitudes towards using robots in healthcare, no prior research has specifically explored their willingness to integrate service robots within the Egyptian healthcare context.AimThe aim of this study was twofold: (a) to explore the behavioral intentions of nurses to accept robots in their workplace, and (b) to examine the willingness of patients to use service robots in healthcare settings.MethodsA mixed-methods study was conducted. Quantitative data were collected from 301 nurses using the Behavioral Intention to Accept Robots in the Workplace Scale and from 467 patients using the Service Robot Integration Willingness Scale through convenience sampling at three tertiary public hospitals in Port Said, Egypt. Qualitative data were obtained through in-depth, semi-structured interviews with 16 nurses, focusing on their perspectives and concerns regarding robot integration. Descriptive analyses were used to analyze quantitative data, and thematic analysis was used to analyze qualitative data.ResultsQuantitative results indicated a moderate level of behavioral intention to use robots among nurses. Patients demonstrated low willingness to use service robots. In the qualitative analysis of the data obtained from the interviews with nurses, three categories (Concerns about Robots, Roles and Competencies, and Potential Benefits) and eight themes (interaction and emotions, maintenance and reliability, job insecurity, role clarity, competence in critical care, trustworthiness, reducing physical strain, and specialized applications) were identified.ConclusionThe results of this study indicate that nurses’ behavioral intention to accept service robots in healthcare settings is moderate and their acceptance is influenced by various factors related to their concerns about robots, roles and competencies, and potential benefits they could gain. Patients showed a low level of willingness to use service robots in healthcare settings.ImplicationProviding targeted educational programs to nurses and patients, assuring them with the provision of robust maintenance protocols, enhancing their confidence in the capabilities of robots, and defining clear roles for robots are crucial for the successful integration of robots into healthcare settings.

Conflict of interest in the securities market

In the article examines the problem of applying the legal interpretation of the concept of “conflict of interest,” including as applicable to legal relations in the stock market. Such concepts as the fiduciary duties of a trustee, the controversial nature of the legal definition of a conflict of interest through the concept of personal interest are considered. The need for further development of the prudential regulation system and a more specific definition of the criteria for the fiduciary duties of the principal in the securities market are substantiated. The possibility of introducing into Russian practice the approach used in the common law system is analyzed. According to this approach, only proof of the fact of dishonest fulfillment of fiduciary duties, such as loyalty, due diligence and information duty can serve as a basis for prosecution in the event of a conflict of interest, but not the establishment of the fact of personal interest. In particular, from this point of view, the fundamental rule of the common law system applied in the stock market is considered — to fully rely on the information (i.e., a situation completely opposite to the approach that has developed in Russian law in relation to identifying conflicts of interest) provided by the broker to the client, and to expect, that he will perform his duties with all competence and due care. The author substantiates the greater effectiveness of the approach of establishing a presumption of conscientious fulfillment of fiduciary duties by a trustee and bringing to responsibility only if the contrary fact is proven.

Comprehensive Airway Quality Improvement Program: Reducing Life-Threatening Airway Complications.

There is often unfamiliarity with the care of artificial airway devices (ie, endotracheal tubes, tracheostomies, and laryngectomies). The objective of this study was to design an Airway Quality Improvement Program (AQIP) to improve airway care. This was a retrospective chart review of a prospectively-initiated AQIP. The AQIP has 3 parts: 1) Mandatory "airway signs" 2) In-service teaching with a corresponding order set and 3) an overhead "Surgical Airway Emergency" page involving automatic pages to Anesthesia, Otolaryngology, and Respiratory Therapy. Pre- and post-intervention survey data was collected. The incidence of airway emergency was the primary patient outcome and was hypothesized to decrease after AQIP intervention. Airway emergencies decreased 8.4% after AQIP (P = .45). Length of stay decreased after AQIP, 47.0 ± 76.5 days compared to 23.5 ± 23.6 (P = .004). Two hundred eight-one nurses and 76 respiratory therapists were educated. Pre-AQIP comfortability scores improved for the routine care of endotracheal tubes, tracheostomies, and laryngectomies, 4.3 ± 0.9, 4.3 ± 0.8, and 3.5 ± 1.2, compared to 4.7 ± 0.6, 4.5 ± 0.7, and 4.4 ± 0.7 post-AQIP (P = .0006, P = .02, P = .0001). The same improvement was noted for emergency airway care. Tracheostomy vs. laryngectomy recognition increased from 66.5 to 97.0% (P = .0001). Quiz questions regarding emergency airway management for laryngectomies improved from 76.2 to 93.8% (P = .0001). The AQIP was associated with decreased length of hospital stay and improved competency in airway care among hospital staff. Further application of AQIP is needed for replication in other institutions and long-term application.

Evaluation of an innovative dementia care competency model among physical and occupational therapy students

ABSTRACT The rising prevalence of dementia calls for a competent workforce capable of delivering quality dementia care. A standard for assessing dementia-care-specific competencies is necessary to guide curriculum development and implementation in a competency-based educational framework during academic training. This study evaluated the psychometric properties of the Dementia Care Competency Model (DCCM) among students enrolled in physical (PT) and occupational therapist (OT) programs. Eighty PT and OT students completed the DCCM by rating the 11 sub-competencies using the National Institute of Health Proficiency Likert Scale. The Exploratory Factor Analysis yielded a Kaiser-Meyer-Olkin of 0.878 and Bartlett’s test significance value of < 0.001, which indicates that the data were very good for factor analysis. The Eigenvalues and scree plot derived two factors with an excellent internal consistency (Cronbach’s alpha = 0.936). When examining the grouping of sub-competencies, the two factors that emerged were patient-centered and interprofessional collaborative care. The DCCM version 2.0 can guide educators in designing learning experiences that target the essential competencies in dementia care, ensuring that PT and OT graduates are well-prepared to work with individuals living with dementia. Future research should refine the model by exploring additional sub-competencies within each domain and expanding the model’s applicability across multiple healthcare disciplines.

The pivotal role of neurosurgeons in transitional care: A comprehensive tertiary healthcare institution's experience.

Transitional care (TC) is increasingly crucial, particularly in neurosurgery, where optimal follow-through of patients' care is paramount. Challenges of transition are exacerbated by the complexity of neurosurgical conditions, with pediatric and adult neurosurgery often managed separately by different attending neurosurgeons or in different institutions. While numerous models for transitioning have been proposed, several barriers persist, impeding successful transfer from pediatric to adult settings. Our review focuses on important roles neurosurgeons can play in facilitating successful transition, exploring some existing TC models, with emphasis on the benefits of maintaining a single provider. Clinic visits data between 2019 to 2023 of patients between the ages of 16 to 26 was compiled retrospectively. Successful transition was defined as continued follow-up moving from pediatric to adulthood with lost to follow-up being that of unsuccessful transition. Age, diagnosis and whether patients were successfully transitioned or lost to follow-up were documented. 1829 neurosurgical patients between the ages of 16 to 26 were identified over 5 years. A snapshot review identified 78 adolescent patients deemed to require follow-up into adulthood. 13 patients had epilepsy, 32 central nervous system (CNS) tumors, 17 congenital conditions, 14 neurovascular, and 2 patients had idiopathic intracranial hypertension. All 78 were noted to have successfully transited into their adulthood (age 21 and beyond). Having the same providers; having pediatric and adult neurosurgery within the same institution, was the single most important factor in facilitating successful transition. Neurosurgeons in institutions, particularly those with experience and competencies in both pediatric and adult care, can serve as crucial anchors during the transitional period. At our institution, the implementation of this continuity of care model has demonstrated remarkable success. Institutions with both pediatric and adult services would be uniquely positioned to develop and implement effective transitional care.

12545 Transgender Healthcare Online Curriculum: A Partnership Between An Academic Medical Center And Corrections Facility

Abstract Disclosure: E. Lamos: None. R. Malek: None. Introduction: The World Professional Association for Transgender Health Standards of Care (WPATH SOC-8) states that all recommendations be applied equally to individuals living in institutions​, including those incarcerated. Studies suggest correctional staff have little training in transgender care.​ To demonstrate a partnership between an academic medical center and a corrections facility and increase knowledge and comfort in transgender healthcare, academic faculty developed an online curriculum as an educational opportunity for state corrections facility staff and clinicians. Methods: There were 6 modules: Overview of Transgender Competent Care, Health Vulnerabilities, Creating an Inclusive Environment, Feminizing and Masculinizing Hormone Treatment, and Preventative Care of the Transgender Individual (Image). The Short Course (first 3 modules) was for staff or clinicians not providing hormone-affirming care and the Full Course (all 6 modules) for clinicians who provide hormone-affirming care. Each module included embedded knowledge assessments and post-module action items. An anonymous pre and post curriculum survey assessed module effectiveness. The project was considered non-human subject research by the Institutional Review Board. Result analysis used the Fisher Exact Test and unpaired t test. Results: 44 corrections staff and clinicians participated (2022-2023) with a 32% post survey response rate. 57% indicated zero prior hours of transgender education with 59% feeling somewhat or extremely comfortable with transgender healthcare. Most were interested in learning about transgender healthcare (Table 1). Participants had a statistical improvement in knowledge and their access to resources were good or excellent after completion (p &amp;lt;0.05, both) (Table 2). Also, for the Short Course, comfort in recognizing barriers to care significantly improved (p&amp;lt;0.05), 100% agreed both with the importance of what they were asked to learn and that knowledge and skills increased. Domains of comfort with transgender healthcare did not statistically change for participants of the Full Course. Participants positively reflected on curriculum content and bias discussion. Full Course respondents requested more therapeutics information. Inclusive interactions were the most frequent practice improvement strategy. Conclusion: This curriculum increased knowledge and improved resources for those providing healthcare to incarcerated transgender patients. The curriculum was inclusive of many diverse types of learner and allowed learners to choose the course that aligned with their clinical role. It meets WPATH SOC-8 recommendations that corrections staff and clinicians receive training in transgender care.​ It highlights the collaboration between an academic medical center and corrections facility, meeting the academic mission to serve marginalized groups. Presentation: 6/1/2024

The relationship between intercultural sensitivity, ethnocentrism, socio-demographic characteristics and xenophobia in nursing students: A descriptive and multi-centric study

BackgroundXenophobia plays a pivotal role in influencing the delivery of culturally competent care. Nevertheless, the relationship between intercultural sensitivity, ethnocentrism, socio-demographic characteristics and xenophobia in nursing students remains undetermined. AimThis study aimed to determine the relationship between intercultural sensitivity, ethnocentrism, socio-demographic characteristics and xenophobia in nursing students. Methods and participantsThe study involved 1045 nursing students from six universities in Türkiye. Data were collected using the “Participant Information Form,” the “Intercultural Sensitivity Scale,” the “Ethnocentrism Scale,” and the “Xenophobia Scale.” Multiple linear regression was employed for the analysis. ResultsIntercultural sensitivity (β = −0.09; p = 0.028) emerged as a negative predictor of xenophobia levels in students, while ethnocentrism (β = 0.17; p = 0.000) was identified as a positive predictor of xenophobia levels. Additionally, socio-demographic characteristics, including age, living in an extended family, academic year, participation in intercultural nursing courses, and interaction with immigrant neighbors, were established as significant predictors of xenophobia. ConclusionThis study revealed a direct correlation between higher intercultural sensitivity and reduced xenophobia, whereas an increase in ethnocentrism was linked to elevated levels of xenophobia. These results offer valuable insights for educators and policymakers to combat xenophobia and design targeted interventions.

Delivering Culturally Competent Care to Migrants by Healthcare Personnel: A Crucial Aspect of Delivering Culturally Sensitive Care

The increasing cultural and ethnic diversity within global migrant populations necessitates the provision of culturally competent care by healthcare personnel. This narrative literature review critically analyzes existing literature on the delivery of culturally competent care to migrants, highlighting key theoretical frameworks, empirical findings, and practical strategies to enhance cultural competence in healthcare settings. The review identifies significant health disparities faced by migrants, including barriers to accessing healthcare, communication challenges, and systemic issues within healthcare institutions. It emphasizes the importance of comprehensive training programs, supportive organizational policies, community engagement, and the innovative use of technology and telemedicine. Furthermore, it addresses the future directions and research gaps, calling for longitudinal studies, the development of robust metrics, and targeted strategies to overcome the digital divide and ensure data privacy. By addressing these areas, healthcare providers, educators, and policymakers can improve healthcare delivery, reduce health disparities, and ensure equitable access to care for migrant populations.

Assessing the frontline competency gap: Emergency care perceptions among nurses in Yemen's conflict zone.

Nursing competencies in armed conflict situations are critical for effective response and recovery. This study explores nurses' perceptions regarding their competencies in armed conflict zones to identify areas of proficiency and those requiring further emphasis in training. This cross-sectional descriptive study adhered to the STROBE reporting guidelines. It used a validated questionnaire examining 47 different competencies for nursing in armed conflict zones, which were subsequently ranked to identify those that were valued most and least. In total, 102 questionnaires were returned (85% response rate). The highest-ranked competencies focused on immediate life-saving interventions and personal safety. In contrast, competencies involving broader disaster management, such as understanding organizational disaster plans, post-death care, and risk identification, ranked lower. This observation may indicate a tendency to prioritize direct clinical care over strategic planning and long-term recovery in disaster nursing education. This study highlights the critical need to strengthen emergency care competencies among nurses working in armed conflict zones in Yemen. Its findings underscore the importance of targeted training programs, particularly in complex trauma management and psychological first aid, to address nurses' self-identified competency gaps. Policy implications include prioritizing resource allocation for emergency care infrastructure, implementing competency-based deployment strategies, and ensuring access to mental health support for nurses in working conflict zones. These actions are essential for building a resilient nursing workforce capable of providing quality care amidst the unique challenges of armed conflict.

Assessing Emergency Department Staff Knowledge, Competency, and Implementation of Pre- and Post-Trauma-Informed Care Training

IntroductionTrauma-informed care has been posited as a framework for creating ideal and safe environments for patients to participate in treatment. However, there are limited studies that demonstrate the impact of a focused trauma-informed care training on ED staff. We implemented a 4-hour trauma-informed care training in a general emergency department. We aimed to measure changes in knowledge, opinions, self-rated competency, barriers, and recent practices before and after implementing trauma-informed care training. We hypothesized that the training would result in significant self-reported improvement in all domains. MethodsWe performed a pre/post interventional study with the intervention being a trauma-informed care training adapted for ED clinical care staff. A validated, publicly available survey tool (Center for Pediatric Stress Trauma-Informed Care [TIC] Provider Survey) was used to assess knowledge, opinions, competency, and utilization of and perceived barriers to trauma-informed care. Pre- and post-training surveys were collected. Responses were stratified by role. Continuous variables were compared using analysis of variance; categorical variables compared using Pearson’s chi-square. ResultsParticipants demonstrated a high level of perceived knowledge and opinions of trauma-informed care before and after training. We observed significant increases in self-reported competence for all ED staff, some increase in utilization of trauma-informed care in recent practice, and significant decreases in perceived barriers to providing trauma-informed care. DiscussionTrauma-informed care training is an effective means to improving ED staff self-perceived competence and practice of trauma-informed care even among those with high self-perceived knowledge and opinions of trauma-informed care before the training. Future study should explore the patient-level impact of trauma-informed care training, as well as how to continue to reduce barriers to system-wide implementation of trauma-informed care practices.

An ICT-enabled community oriented primary care intervention in mining communities during COVID-19 (2019–2022): perceived changes in the role and place of community health workers

BackgroundThis is a study of service provider perceptions of the place, role and practices of CHWs in a four-year, large-scale private sector funded, public service ICT-enabled COPC intervention with rural and remote mining communities. Like all South African communities, apart from large mining house employees and some contractors, most people use available public healthcare services and private traditional as well as limited allopathic private sector providers. In addition to the limitations of facility centred primary healthcare and a fragmented health care system, the many negative health effects of mining on the communities, go unattended.MethodsThis is a rapid, qualitative pragmatic study. Using site and participation convenience sampling, 37 semi-structured individual or group interviews were conducted with 57 stakeholders from 38 of the 135 intervention PHC facilities. Using a data driven, inductive approach, the results were analysed thematically in terms of perceived changes in the role and place of CHWs.ResultsCHWs registered 42 490 households and captured the demographic and social profiles as well as the health status of over 154 910 individuals using AitaHealth™. These data provided healthcare professionals and managers with knowledge about community demographics, at-risk groups and vulnerable individuals. The intervention changed the locational focus of CHW practice and expanded their scope of work and competencies in household comprehensive health education, advice and care. It led to a growth in community and professional confidence in CHWs as trusted members of mining community PHC teams and to more focused and efficient clinic work.ConclusionThis ICT-enabled COPC intervention adopted a comprehensive approach to healthcare delivery that started by including CHWs in PHC teams and locating them in communities. Inclusive and systematic continuous learning, clinically-led CHW service support and ICT-enabled information technology engendered trust in CHWs as competent PHC members, and grew community confidence in them and the PHC system as a whole. Although health, care and other professionals and workers valued the changes the intervention brought to their work as well as people’s lives in underserved and vulnerable mining communities, its sustainability is contingent on the vagaries of political will and financial commitment.

Reframing covenant for nursing: From individual commitments to covenant with society.

Today's constrained healthcare environment can make it very difficult for nurses to provide compassionate, competent, and ethical care, and yet their continued commitment to care is viewed as requisite. Nurses' commitment to care of patients, enmeshed with professional identity, may be understood as heroic. A few nursing scholars have advanced the concept of a nurse-patient covenant to explain or inspire nurses' commitment to care. Covenant describes an enduring relationship characterised by mutual promises and generous responsiveness. However, recent critique has revealed a general misunderstanding and misuse of the term covenant in much of the nursing literature whereby individual nurses are improperly and impossibly idealised as holding sole responsibility in the commitment to care. Such an interpretation obscures society's responsibilities in caring for both patients and nurses and contributes to the idealisation of nurses' commitment to extend themselves to fill in healthcare system gaps. Yet, the concept of a covenant relationship, when reframed as occurring between society and the profession of nursing, may lead us toward solutions to the very problems the originally misused concept sustained. Evidence within healthcare systems globally suggests that nurses' commitments are fragile or fragmented under duress due to increasing pressure, demands, and even risks. A reframing of covenant has the common good for society and nursing at its core and, we argue, may lead to a more sustainable nursing identity. We present the results of an exploratory project, undertaken to examine the utility and suitability of covenant as a relational framework for nursing. We explore a reframing of a covenant of care as a relationship between nursing and society, which may provide a fruitful path toward a sustainable, shared commitment for healthcare. This covenant of care re-centres shared work-a joint responsibility between society and nursing-as necessary for the common good.

Empathy and LGBTI perspectives among university nursing students in Türkiye

ObjectiveThe research aims to understand the factors influencing nursing students' attitudes towards the LGBTI community, given the importance of culturally competent and inclusive care in healthcare. MethodA descriptive and relationship-seeking design was used. The study was completed by 386 nursing students. Data were collected with “Personal Information Form, LGBTI Attitude Scale (LGBTI-AS) and Toronto Empathy Scale (TEQ)”. Hierarchical regression analysis was used to identify predictors of attitudes towards LGBTI individuals among nursing students. ResultsThe total mean score of the Awareness to LGBTI Attitude Scale was 2.47 ± 1.0 (moderate attitudes). The findings revealed that female students and senior nursing students exhibited more positive attitudes, while those with friendships with LGBTI individuals and higher empathy levels showed greater acceptance and understanding towards the LGBTI community (p < 0.001). The results showed that 22 % of the total variance in the LGBTI attitude could be explained in model 3 (F = 27.43, R2 variation = 0.224, p = 0.001). ConclusionThe study highlights the importance of integrating LGBTI-related content into nursing curricula and promoting empathy-building activities. These findings underscore the significance of empathy in shaping positive attitudes and emphasize the need for comprehensive educational strategies to promote inclusivity in healthcare.

Assessment of Perceived Diversity and Inclusivity of Athletic Training Textbooks

Context Adopting diverse perspectives is increasingly important for athletic trainers (ATs) to provide care that fosters inclusion for all patients. Despite the NATA’s commitment to diversity, NATA membership remains approximately 80% White. Additionally, although ATs work with people from ethnically diverse backgrounds with unique body expression and body-size characteristics, it is unknown whether athletic training textbooks represent this diversity. Objective To investigate diversity characteristics of images including patients and clinicians within athletic training textbooks. Design Cross-sectional study. Patients or Other Participants Twenty percent (n = 15) of athletic training and health care textbooks included on the Board of Certification reference list were selected. Twenty percent of chapters from those textbooks were then randomly selected for inclusion. Main Outcome Measure(s) Descriptive statistics were calculated for person (athlete, nonathlete, clinician), setting (athletic venue, clinic, physician office, other), and demographic categories (perceived skin tone, race/ethnicity, age, gender, body size, body expression). Chi-square tests of goodness of fit were performed to determine significant differences between categories, and χ2 tests of independence were performed to determine differences across person type and category and across textbook domain and category. Results One thousand six hundred sixty-seven people were assessed from 1190 images. Images depicted statistically more persons with light skin tone (86%) assumed to be White (86%), young adults (75%) of average weight (95%), with no body expression diversity (95%). There were no major differences in subject characteristic majorities across person type or textbook domain. Conclusions Like other health care professions, a lack of image diversity was demonstrated within athletic training textbooks. To better recruit diverse students to the athletic training profession, and to prepare professional students to provide culturally competent and patient-centered care, these resources should better represent the diversity of ATs and their patients.

Differential prevalence of psychiatric disorders and mental health characteristics associated with lifetime suicide attempts in the Asian American and Pacific Islander adult population

BackgroundAsian American and Pacific Islander (AAPI) adults are an understudied group in terms of their mental health and mental healthcare needs. This has been complicated by the difficulty of recruiting adequate national samples of AAPI adults for research. ObjectiveThis study aimed to analyze national data to examine the lifetime prevalence of major psychiatric disorders among AAPI adults relative to non-AAPI adults, as well as to identify and compare sociodemographic and clinical characteristics associated with lifetime suicide attempts among AAPI and non-AAPI adults. MethodsCross-sectional data on 36,109 adults, including 1801 AAPI adults, from the National Epidemiological Survey of Alcohol and Related Conditions-III (NESARC-III), were analyzed with a series of chi-square and logistic regression analyses. ResultsWe found a significantly lower lifetime prevalence of mental health disorders in the AAPI versus the non-AAPI population nationally, including 2% of AAPI adults reporting lifetime suicide attempts as compared to about 5% of non-AAPI adults. Female sex and a history of major depressive disorder diagnosis were associated with lifetime suicide attempts in the AAPI and non-AAPI populations. Several unique factors were associated with having a history of suicide attempts in only the AAPI population, including a military service history and a diagnosis of panic disorder. DiscussionOur analysis demonstrated the significant sectors of the AAPI population that merit research, support, and intervention, including the AAPI veteran population. This study identifies several characteristics among AAPI adults that may make them particularly vulnerable to psychiatric problems and suicide risk, which may inform targeted prevention and efforts to provide culturally competent care to this population.

Impact of moral resilience and interprofessional collaboration on nurses' ethical competence.

Home care nurses are central in providing holistic and compassionate care to patients in home-based palliative care. Ethical caring competency is essential for home care to sustain nurses' integrity in the face of moral adversity. Interprofessional collaboration is vital for ensuring ethical decision-making and providing patient-centered care in home-based palliative care settings. This study explored the predictive roles of interprofessional collaboration and moral resilience on ethical caring competency among home care nurses in home-based palliative care. A cross-sectional survey of 400 nurses was conducted from October to December 2023, utilizing standardized scales to measure interprofessional collaboration, moral resilience, and ethical caring competency. A convenience sample of 400 home care nurses was also included in this study. Correlation and linear regression analysis were used to clarify the associative and predictive findings. Ethical approval from the ethics committee, institutional permission, and informed consent from the participants were obtained for data collection. Correlation analysis showed significant positive correlations between the ethical caring competency, interprofessional collaboration, and moral resilience constructs, with coefficients ranging from 0.482 to 0.967. Linear regression revealed that management of collaborative systems and total moral resilience significantly predict ethical caring competency, explaining 14.6% and 36.6% of its variance, respectively. Other variables, such as the effects of collaboration and communication, did not significantly influence ethical caring competency. The study highlights the significant impact of interprofessional collaboration, particularly the management of collaborative systems and moral resilience, on enhancing ethical caring competency among nurses. Enhancing interprofessional collaboration and moral resilience through targeted strategies in nursing practice and education can significantly improve ethical caring competencies. These efforts are essential for delivering high-quality, patient-centered care and for fostering a healthcare environment that respects the ethical principles guiding nursing practice.

Assessing gaps in predoctoral dental curriculum for LGBTQ+ specific content.

Despite growing recognition of health disparities faced by the Lesbian, Gay, Bisexual, Transgender, Queer (or Questioning) (LGBTQ+) population, significant gaps remain for inclusion of LGBTQ+ content in health professions education, particularly dental curricula. This study aims to address these gaps by investigating the integration of LGBTQ+ content in a midwestern dental school curriculum. Curriculum mapping and focus group discussions were utilized to identify gaps and recommend integrating LGBTQ+ content into a predoctoral dental curriculum. The Doctor of Dental Surgery program was mapped to identify LGBTQ+ specific content relevant to cultural competency. A focus group of ninefaculty members provided insights and recommendations, with data transcribed and analyzed for themes. Out of 121 courses, 28 included or had potential for LGBTQ+ content, with 16 already inclusive and 12 involving direct patient interaction. Integration varied, highest in the first year (28.6%) and lowest in the fourth year (5%). Focus group themes included the need for broader awareness and education about LGBTQ+ health, integrating topics into basic and behavioral science courses, and addressing practical clinical skills (e.g., using pronouns). Barriers included personal discomfort, lack of formal training, and potential conflicts with personal or religious beliefs. This study highlighted the need for increased faculty awareness and enhanced inclusion of LGBTQ+ content throughout the predoctoral dental curriculum to prepare future practitioners for culturally competent care.